Evidence map›Paper›PMID 33948809›Full record

ArticleInternational urology and nephrology2021

Treatment of infants with ureteropelvic junction obstruction: findings from the PURSUIT network.

Vijaya M Vemulakonda, Carter Sevick, Elizabeth Juarez-Colunga, George Chiang, Nicolette Janzen, Alison Saville, Parker Adams, Gemma Beltran, Jordon King, Emily Ewing and 1 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in International urology and nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 1 country.

Vijaya M VemulakondaPediatric Urology Research Enterprise, Department of Pediatric Urology, Division of Urology, Department of Surgery, Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, 13123 East 16th Avenue, Mailbox B-463, Aurora, CO, 80045, USA. Vijaya.Vemulakonda@childrenscolorado.org.
Carter SevickAdult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
Elizabeth Juarez-ColungaDepartment of Biostatistics and Informatics, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
George ChiangDepartment of Pediatric Urology, Department of Urology, Rady Children's Hospital San Diego, University of California San Diego, San Diego, CA, USA.
Nicolette JanzenDepartment of Pediatric Urology, Department of Urology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Alison SavilleAdult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
Parker AdamsPediatric Urology Research Enterprise, Department of Pediatric Urology, Division of Urology, Department of Surgery, Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, 13123 East 16th Avenue, Mailbox B-463, Aurora, CO, 80045, USA.
Gemma BeltranPediatric Urology Research Enterprise, Department of Pediatric Urology, Division of Urology, Department of Surgery, Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, 13123 East 16th Avenue, Mailbox B-463, Aurora, CO, 80045, USA.
Jordon KingDepartment of Pediatric Urology, Department of Urology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Emily EwingDepartment of Pediatric Urology, Department of Urology, Rady Children's Hospital San Diego, University of California San Diego, San Diego, CA, USA.
Allison KempeAdult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
University of Colorado Denver · USChildren's Hospital Colorado · USBaylor College of Medicine · USRady Children's Hospital-San Diego · USTexas Children's Hospital · USUniversity of California, San Diego · USUniversity of Colorado Anschutz Medical Campus · US

Funding

Understanding Practice Variations in Treatment of Infants with Suspected UPJ ObstructionK08HS024597 · AHRQ · UNIVERSITY OF COLORADO DENVER · PI VEMULAKONDA, VIJAYA M. · 2016 to 2020
$744k
Agency for Healthcare Research and Quality K08 HS024597-01AHRQ HHS K08 HS024597
6 · The paper itself

Abstract

purposeStudies based on administrative databases show that infant pyeloplasty is associated with minority race/ethnicity but lack clinical data that may influence treatment. Our objective was to identify clinical and demographic factors associated with pyeloplasty in infants from three large tertiary centers.

methodsWe reviewed infants with unilateral Society for Fetal Urology (SFU) grade 3-4 hydronephrosis seen at three tertiary centers from 2/1/2018 to 9/30/2019. Patients were excluded if > 6 months old or treated surgically prior to the initial visit. Outcomes were: pyeloplasty < age 1 year and SFU grade on most recent ultrasound (US) within the first year. Covariables included: age at the initial visit, race/ethnicity, treating site, insurance type, febrile UTI, and initial imaging findings. Univariable and multivariable analyses were performed using log-rank tests and Cox proportional hazards models, respectively.

results197 patients met study criteria; 19.3% underwent pyeloplasty. Pyeloplasty was associated with: treating site (p = 0.03), SFU 4 on initial US (p = 0.001), MAG-3 (p < 0.001), and T½ > 20 min (p < 0.001) in patients undergoing a MAG-3 (n = 107). MAG-3 (p < 0.001) and location (p = 0.08) were associated with earlier time to pyeloplasty on multivariable Cox analysis. In infants with follow-up US (n = 115), initial SFU grade, MAG-3 evaluation or findings, and pyeloplasty were not associated with improvement of hydronephrosis.

conclusionsWe found that infant pyeloplasty rates vary between sites. Prolonged T½ was associated with surgery despite prior studies suggesting this is a poor predictor of worsening dilation or function. These findings suggest the need to standardize evaluation and indications for intervention in infants with suspected UPJ obstruction.

Indexed as

HumansHydronephrosisInfantKidney PelvisTreatment OutcomeUreteral ObstructionUrologic Surgical ProceduresElectronic health recordPractice patternsPrenatal hydronephrosisUreteropelvic junction obstruction

Identifiers

PMID33948809
PMCPMC8282718
OpenAlexW3158417982

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.